The greenbeard gene tgrB1 regulates altruism and cheating in Dictyostelium discoideum

Greenbeard genetic elements encode rare perceptible signals, signal recognition ability, and altruism towards others that display the same signal. Putative greenbeards have been described in various organisms but direct evidence for all the properties in one system is scarce. The tgrB1-tgrC1 allorecognition system of Dictyostelium discoideum encodes two polymorphic membrane proteins which protect cells from chimerism-associated perils. During development, TgrC1 functions as a ligand-signal and TgrB1 as its receptor, but evidence for altruism has been indirect. Here, we show that mixing wild-type and activated tgrB1 cells increases wild-type spore production and relegates the mutants to the altruistic stalk, whereas mixing wild-type and tgrB1-null cells increases mutant spore production and wild-type stalk production. The tgrB1-null cells cheat only on partners that carry the same tgrC1-allotype. Therefore, TgrB1 activation confers altruism whereas TgrB1 inactivation causes allotype-specific cheating, supporting the greenbeard concept and providing insight into the relationship between allorecognition, altruism, and exploitation.

A novel cubic-exp evaluation algorithm considering non-symmetrical axial response signals of confocal microscopes

The depth discrimination in confocal microscopy is based on the digital analysis of depth response signals obtained by each camera pixel during measurement. Various signal-processing algorithms are used for this purpose. The accuracy of these algorithms is inter alia restricted by the axial symmetry of the signals. However, in practice response signals are rather asymmetrical especially in case of measurement objects with critical surface structures such as edges or steep flanks. We present a novel signal-processing algorithm based on an exponential function with a cubic argument to handle asymmetrical and also symmetrical depth response signals. Results obtained by this algorithm are compared to those of commonly used signal processing algorithms. It turns out that the novel algorithm is more robust, more accurate and exhibits a repeatability of a similar order compared to other algorithms. RESEARCH HIGHLIGHTS: A novel, more robust algorithm with improved accuracy in peak extraction especially for asymmetrical response signals in confocal microscopy is introduced and validated. Improved accuracy is demonstrated for height and layer thickness measurements.

Global Soil Hydraulic Properties dataset based on legacy site observations and robust parameterization

The representation of land surface processes in hydrological and climatic models critically depends on the soil water characteristics curve (SWCC) that defines the plant availability and water storage in the vadose zone. Despite the availability of SWCC datasets in the literature, significant efforts are required to harmonize reported data before SWCC parameters can be determined and implemented in modeling applications. In this work, a total of 15,259 SWCCs from 2,702 sites were assembled from published literature, harmonized, and quality-checked. The assembled SWCC data provide a global soil hydraulic properties (GSHP) database. Parameters of the van Genuchten (vG) SWCC model were estimated from the data using the R package 'soilhypfit'. In many cases, information on the wet- or dry-end of the SWCC measurements were missing, and we used pedotransfer functions (PTFs) to estimate saturated and residual water contents. The new database quantifies the differences of SWCCs across climatic regions and can be used to create global maps of soil hydraulic properties.

Polarization dependency of the 3D transfer behavior in microsphere enhanced interferometry

Enhancing the lateral resolution limit in optical microscopy and interferometry is of great interest in recent research. In order to laterally resolve structures including feature dimensions below the resolution limit, microspheres applied in the optical near-field of the specimen are shown to locally improve the resolution of the imaging system. Experimental and simulated results following this approach obtained by a high NA Linnik interferometer are analyzed in this contribution. For further understanding of the transfer characteristics, measured interference data are compared with FEM (finite element method) based simulations with respect to the polarization dependency of the relevant image information.

Annual precipitation explains variability in dryland vegetation greenness globally but not locally

Dryland vegetation productivity is strongly modulated by water availability. As precipitation patterns and variability are altered by climate change, there is a pressing need to better understand vegetation responses to precipitation variability in these ecologically fragile regions. Here we present a global analysis of dryland sensitivity to annual precipitation variations using long-term records of normalized difference vegetation index (NDVI). We show that while precipitation explains 66% of spatial gradients in NDVI across dryland regions, precipitation only accounts for <26% of temporal NDVI variability over most (>75%) dryland regions. We observed this weaker temporal relative to spatial relationship between NDVI and precipitation across all global drylands. We confirmed this result using three alternative water availability metrics that account for water loss to evaporation, and growing season and precipitation timing. This suggests that predicting vegetation responses to future rainfall using space-for-time substitution will strongly overestimate precipitation control on interannual variability in aboveground growth. We explore multiple mechanisms to explain the discrepancy between spatial and temporal responses and find contributions from multiple factors including local-scale vegetation characteristics, climate and soil properties. Earth system models (ESMs) from the latest Coupled Model Intercomparison Project overestimate the observed vegetation sensitivity to precipitation variability up to threefold, particularly during dry years. Given projections of increasing meteorological drought, ESMs are likely to overestimate the impacts of future drought on dryland vegetation with observations suggesting that dryland vegetation is more resistant to annual precipitation variations than ESMs project.

Three-dimensional transfer function of optical microscopes in reflection mode

Three-dimensional (3D) transfer functions build the basis for a comprehensive characterization of optical imaging systems in the spatial frequency domain. Utilizing the projection-slice theorem, the 2D modulation transfer function of an incoherent imaging system can be derived from a 3D transfer function by integration with respect to the axial spatial frequency. For a diffraction limited microscope with homogeneous incoherent pupil illumination, the modulation transfer function equals the 2D autocorrelation function of a circular disc. However, until now to the best of our knowledge no 3D transfer function has been published, which exactly leads to the 2D modulation transfer function of a diffraction limited microscope in reflection mode. In this article, we derive a formula, which after integration with respect to the axial spatial frequency coordinate perfectly fits to the diffraction limited 2D modulation transfer function. The inverse three-dimensional Fourier transform of the 3D transfer function results in a complex-valued 3D point spread function, from which the depth of field, the lateral resolution and, in addition, the corresponding 3D point spread function of both, a conventional and an interference microscope, can be obtained.

Induktion einer strickleiterartigen Narbe an der Wange einer 28-jährigen Frau nach Laserung eines Naevus araneus mittels KTP-Laser

Die 28-jährige Patientin stellte sich zur Behandlung einer kosmetisch störenden Gefäßläsion an der Wange vor. Es wurde eine Lasertherapie vorgeschlagen und vereinbart. Es entstanden unmittelbar nach der Laserbehandlung Schmerzen und eine Rötung; später eine entstellende Narbe.

Die Gutachter der Gutachterkommission bei der Ärztekammer Nordrhein beurteilten die Behandlung als fehlerhaft.

Laserbehandlungen zählen insgesamt zu den risikoreicheren Therapien in der Dermatologie. Häufiger als andere Behandlungsoptionen beurteilen die Begutachter die Behandlungen als fehlerhaft.

Patientensicherheit: Die Lasertherapie gehört zu den risikoreicheren Therapieoptionen in der Dermatologie

Seit der Erstbeschreibung von Lasern und den ersten Anwendungen in der Dermatologie hat die Lasertherapie innerhalb des dermatologischen therapeutischen Armamentariums enorm an Bedeutung zugenommen.

Da sie häufig bei ästhetischen Indikationen Anwendung findet, sind hohe Sicherheitsanforderungen zu gewährleisten, ansonsten kommt es zu unangenehmen juristischen Streitigkeiten. Eine retrospektive Analyse anhand der Fälle der Gutachterkammer für ärztliche Behandlungsfehler hat gezeigt, dass Lasertherapien zu den risikoreicheren therapeutischen Optionen in der Dermatologie gehören.

Human Papillomavirus-type distribution in anogenital lesions of prepubertal children

BACKGROUND

In contrast to adults, only limited data are available on the human papillomavirus (HPV)-type spectrum in anogenital warts (AGW) of children.

OBJECTIVE

This study aimed to evaluate the HPV-type spectrum in AGW of prepubertal children.

MATERIALS & METHODS

In a retrospective German multicentre study, HPV genotyping was performed in AGW biopsies of 55 1- to 12-year-old children using HPV group-specific PCRs followed by hybridization with type-specific probes or sequence analysis.

RESULTS

Human papillomavirus-DNA was found in 53 of the 55 AGW. In 58.5% (31/53) of the HPV-positive AGW, mucosal HPV types were detected. HPV6 (27/53, 50.9%) was the predominant type. 43.4% (23/53) of the lesions were induced by cutaneous HPV types (HPV2, HPV27, HPV57). Mucosal HPV types were significantly more common in children under 5 years of age than in children 5 years of age and older (22/25, 88.0% [95% CI: 70.0-95.8] vs. 9/28, 32.1% [95% CI: 17.9-50.7], P < 0.001). In contrast, cutaneous HPV types were significantly more prevalent in the 5- to 12-year age group (4/25, 16.0% [95% CI 6.4-34.7] vs. 19/28, 67.9% [95% CI 49.3-82.1], P < 0.001).

CONCLUSION

Anogenital warts in 5- to 12-year-old children are frequently associated with cutaneous HPV types, possibly due to horizontal transmission. HPV typing, in addition to comprehensive clinical and psychosocial evaluation, can potentially help in the assessment of these cases.

3D modeling of coherence scanning interferometry on 2D surfaces using FEM

Despite the fact that optical profilers, such as coherence scanning interferometers, are frequently used for fast and contactless topography measurements in various fields of application, measured profiles still suffer from the wave characteristics of light, which leads to systematic deviations that are still not sufficiently investigated. In order to analyze these systematic deviations and their physical relations, we apply a rigorous simulation model considering both the transfer characteristics of the measurement instrument as well as the geometry and material of different measurement objects. Simulation results are compared to measurement results for different polarizations, wavelengths and interferometer types, considering surface structures including edges, slopes and different materials as the main reasons for those deviations. Compared to former publications, a full three-dimensional (3D) modeling of the image formation with regard to two-dimensional (2D) surface structures is provided. The advantages of 3D modeling in contrast to a time efficient 2D approach are discussed. Further, an extract of an atomic force microscope (AFM) measurement result is used as the basis for the FEM simulation in one example in order to achieve most realistic simulation results.

A GoldenBraid cloning system for synthetic biology in social amoebae

GoldenBraid is a rapid, modular, and robust cloning system used to assemble and combine genetic elements. Dictyostelium amoebae represent an intriguing synthetic biological chassis with tractable applications in development, chemotaxis, bacteria–host interactions, and allorecognition. We present GoldenBraid as a synthetic biological framework for Dictyostelium, including a library of 250 DNA parts and assemblies and a proof-of-concept strain that illustrates cAMP-chemotaxis with four fluorescent reporters coded by one plasmid.

Sklerodermiformes Basalzellkarzinom an der Wange unter der (Fehl-)Diagnose einer Aknenarbe

Eine Patientin stellte sich 4 Mal vor etwa 10 Jahren und vor 6 Jahren bei dem beklagten Hautarzt zum Hautkrebsscreening vor. In der ärztlichen Dokumentation wurde jeweils eine Narbe aufgrund einer Akne tarda befundet. Vor 2 Jahren stellte sich die Patientin bei einem anderen Hautfacharzt vor, der eine Biopsie entnahm, die ein sklerodermiformes Basalzellkarzinom ergab. Es musste eine komplexe operative Sanierung durchgeführt werden mit entsprechenden Komplikationen wie Nervenschädigungen, Gefühlsstörungen und Formveränderungen des Gesichtes. Die Gutachterkommission hat dies als Befunderhebungsfehler dem beklagten Arzt attestiert, zumal er nach dem 4., aber spätestens nach dem 5. Vorstellungsbesuch zum Hautkrebsscreening seine Diagnose mittels einer Probebiopsie hätte überprüfen müssen. Dies entspricht dem Facharztstandard, dem das Vorgehen des Facharztes in diesem Falle nicht gerecht wurde.

Improved Cervical Cord Lesion Detection with 3D-MP2RAGE Sequence in Patients with Multiple Sclerosis

Spinal cord lesions have a real diagnostic and prognostic role in multiple sclerosis. Thus, optimizing their detection on MR imaging has become a central issue with direct therapeutic impact. In this study, we compared the 3D-MP2RAGE sequence with the conventional Magnetic Resonance Imaging in Multiple Sclerosis (MAGNIMS) set for cervical cord lesion detection in 28 patients with multiple sclerosis. 3D-MP2RAGE allowed better detection of cervical lesions (+62%) in this population, with better confidence, due to optimized contrast and high spatial resolution.

Auftreten des Post-Finasterid-Syndroms nach Verschreibung von Propecia 1 mg-Tablette zur Behandlung der männlichen Glatzenbildung

Ein Patient wurde im Jahre 2013 mit Propecia 1 mg aufgrund einer androgenetischen Alopezie behandelt. Es traten bei ihm eine sexuelle Dysfunktion mit Erektionsschwäche und vermindertem sexuellen Verlangen auf, die auch nach Abbrechen der Therapie anhielt. Daraufhin machte der Patient gegenüber dem Facharzt einen Behandlungsfehler geltend aufgrund mangelhafter Aufklärung mit der Konsequenz einer fehlerhaften Behandlung. Der urologische Fachgutachter bejahte den Behandlungsfehler. Er war der Meinung, dass, auch wenn nur Einzelfälle mit geringer wissenschaftlicher Basis über das Post-Finasterid-Syndrom bekannt wären, der Facharzt über diese schwerwiegende Nebenwirkung den Patienten hätte aufklären müssen, dies insbesondere bei einer rein kosmetischen Indikation männlicher Glatzenbildung.

Der dermatologische Gutachter schloss sich nicht dieser Meinung an. Im Verordnungsjahr 2013 existierten lediglich 2 Publikationen über Einzelfälle des Post-Finasterid-Syndroms. Diese Publikationen in peripheren Zeitschriften fanden noch kein allgemeines wissenschaftliches Echo und führten auch nicht zur Änderung der Fachinformation. Erst im Verlauf der Folgejahre wurde in der Postmarketing-Phase das Syndrom öfters beschrieben und fand auch Eingang in die Fachinformation. Da für die Beurteilung das im Jahre der Verordnung geltende wissenschaftliche Wissen entscheidend ist, kann dem Facharzt kein Behandlungsfehler vorgeworfen werden.

Gas-loading furnace for deuterium-charged alloy-casting

A furnace was developed and characterized to allow for safe and controlled gas-loading or degassing of alloys. This oven is able to process samples under varying atmospheres, such as high vacuum or nitrogen containing 10 vol. % deuterium, as well as for pressures up to 800 hPa. Thermal desorption spectroscopy and scanning electron microscopy demonstrate the enhancing effects of high loading-gas concentration, high pressures, high temperatures above liquidus (50-150 K above the liquidus temperature of the cast hypoeutectic aluminum-copper model-alloy), and long holding times (up to 60 min) on the amount of retained gas in the solidified sample. Lack of copper segregation in the casting is confirmed by energy dispersive x-ray diffraction and Rutherford backscattering spectroscopy. It is shown that the facility allows for the controlled generation of distinct amounts of gas pores, down to a nil amount (only shrinkage porosity appearing in the sample).

Microsphere-assisted interferometry with high numerical apertures for 3D topography measurements

Improving the lateral resolution is a key focus of the research on optical measuring systems to expand the fields of application for optical metrology. By means of microspheres put on an object in a microscope, and therefore used as a near-field support, it has already been shown that a superresolution of structures below Abbe's diffraction limit is possible. The following investigations give more detailed theoretical and experimental insight into the physical mechanisms responsible for the transition of near-field information to the far field. In particular, the effects of microspheres as near-field support on the behavior of phase-evaluating interference microscopes close to the optical resolution limit are studied experimentally as well as with numerical simulations. Special attention is drawn to measured data taken with a Linnik microscope of high numerical aperture. Finally, the measurement results of grating structures with a period below Abbe's diffraction limit are presented.

Adaptive high-resolution Linnik interferometry for 3D measurement of microparticles

Tailored 3D microparticles and nanostructures lead to increasing possibilities in semiconductor industry or biomedical applications. In an interdisciplinary study we investigate the parallel production of such particles by using nanoimprint lithography in combination with their characterization based on interference microscopy. In this Letter we report on a metrological inspection, which tends to a universal measurement solution comparing the sample optically to a master object produced in the same way as the sample.

Quadrature-based interferometry using pulsed RGB illumination

This contribution introduces a novel image recording approach for phase retrieval in a RGB-interferometer setup with pulsed LED illumination and an oscillating reference mirror. The effective acquisition time of the interference images is below 100 μs with a repetition rate of 10 frames per second. The pulsed illumination is synchronized with the exposure gap of a Bayer-Pattern CMOS RGB camera to enable the recording of two π/2 phase shifted images with a short delay compared to the camera exposure time. The proposed quadrature method enables surface phase retrieval with a standard deviation of ≈ [3 nm, · · ·, 5 nm], depending on phase noise and actuator precision. The applicability of the reconstructed phase data to unambiguity range extension algorithms based on the exact fraction method is considered. Experimental results demonstrate the feasibility of the setup to measure the topography of samples in motion or oscillating by mechanical vibrations.

Temporal high-resolution evaluation algorithm for sinusoidally phase modulated interference signals

In this paper, we present a practical approach for phase analysis of sinusoidally phase shifted interference signals, which are generally used to detect optical path length changes in one arm of the interferometer based on an algorithm introduced by de Groot. We describe the original algorithm from our point of view and try to emphasize the limitations and some details that need to be known for practical implementation. We introduce methods for how to overcome these limitations, and in addition, we provide an extension of the algorithm to a temporal high-resolution mode, which provides a possibility to calculate a phase value for each sampled point of an interference signal and opens new applications for the existing measurement devices without any hardware changes. Simulated and experimental results verify our extensions.

Fiber-bundle model with time-dependent healing mechanisms to simulate progressive failure of snow

Snow is a heterogeneous material with strain- and/or load-rate-dependent strength. In particular, a transition from ductile-to-brittle failure behavior with increasing load rate is observed. The rate-dependent behavior can partly be explained with the existence of a unique healing mechanism in snow that stems from its high homologous temperature (temperature close to melting point). As soon as broken elements in the ice matrix get in contact, they start sintering and the structure may regain strength. Moreover, the ice matrix is subjected to viscous deformation, inducing a relaxation of local load concentrations and, therefore, further counteracting the damage process. Ideal tools for studying the failure process of heterogeneous materials are the fiber-bundle models (FBMs), which allow investigating the effects of basic microstructural characteristics on the general macroscopic failure behavior. We present an FBM with two concurrent time-dependent healing mechanisms: sintering of broken fibers and relaxation of load inhomogeneities. Sintering compensates damage by creating additional intact, load-supporting fibers which lead to an increase of the bundle strength. However, the character of the failure is not changed by sintering alone. With combined sintering and load relaxation, load is distributed from old stronger fibers to new fibers that carry fewer load. So as we additionally incorporated load redistribution to the FBM, the failure occurred suddenly without decrease of the order parameter-describing the amount of damage in the bundle-and without divergence of the fiber failure rate. Moreover, the b value, i.e., the power-law exponent of frequency-magnitude statistics of fibers breaking in load redistribution steps, at failure converged to b≈2, a value higher than that of a classical FBM without healing (b=3/2). These results indicate that healing, as the combined effect of sintering and load relaxation, changes the type of the phase transition at failure. This change of the phase transition is important for quantifying or predicting the failure (e.g., by monitoring acoustic emissions) of snow or other materials for which healing plays an important role.

Discourse After a Batterer Intervention Program: A Qualitative Analysis of "Letters From the Future"

This exploratory study employs discourse and narrative analysis to assess men's ( n = 45) responses to a writing assignment completed at the end of a solution-focused voluntary batterer intervention program. The study finds that the men primarily use the assignment to reassure themselves of their future success, defined through traditionally male paradigms. The narrative analysis then divides the letters according to type: Participants (22.7%) use a "transformative" discourse of behavior change and intimate partner violence (IPV)-sustaining discourse (18.2%), but the plurality (38.6%) use both simultaneously. The ideological conflict demonstrated in these responses highlights how IPV-sustaining discourse is embedded within broader sociocultural discursive structures.

Coherence scanning and phase imaging optical interference microscopy at the lateral resolution limit

To get physical insight into the 3D transfer characteristics of interference microscopy at high numerical apertures we study reflecting rectangular grating structures. In general, the height obtained from phase information seems to be reduced, whereas height values resulting from coherence scanning sometimes seem to be systematically overestimated. Increasing the numerical aperture of an interference microscope broadens the spectra of the resulting interference signals, thus offering a broad variety of wavelength contributions to be analyzed. If phase analysis of a measured far-field interference wavefront is performed at very short wavelengths the periodical profiles obtained from coherence scanning and phase shifting analysis differ only by the measured amplitude. However, at longer wavelength there is a 180° phase shift of the measured profiles obtained from phase analysis compared to coherence peak analysis. Increasing the evaluation wavelength improves the lateral resolution since the long wavelength contributions are related to electromagnetic waves of high angles of incidence. This behavior is to the best of our knowledge not documented in literature so far. It was first observed experimentally and could be confirmed by simulation results obtained from either Kirchhoff diffraction theory or an extended Richards-Wolf model developed in our group. Compared to original input profiles used for the simulation the profiles obtained from phase evaluation correspond quite well at longer wavelength, whereas the results obtained from coherence peak analysis are typically inverted with respect to height.

Group refractive index quantification using a Fourier domain short coherence Sagnac interferometer

The group refractive index is important in length calibration of Fourier domain interferometers by transparent transfer standards. We demonstrate accurate group refractive index quantification using a Fourier domain short coherence Sagnac interferometer. Because of a justified linear length calibration function, the calibration constants cancel out in the evaluation of the group refractive index, which is then obtained accurately from two uncalibrated lengths. Measurements of two standard thickness coverslips revealed group indices of 1.5426±0.0042 and 1.5434±0.0046, with accuracies quoted at the 95% confidence level. This agreed with the dispersion data of the coverslip manufacturer and therefore validates our method. Our method provides a sample specific and accurate group refractive index quantification using the same Fourier domain interferometer that is to be calibrated for the length. This reduces significantly the requirements of the calibration transfer standard.

UV-B-Therapie von Hautkrankheiten: ein Update zu Indikationen, Wirksamkeit, Nebenwirkungen und Durchführung

Seit Anfang des 20. Jahrhunderts ist die UV-B-Phototherapie eine der tragenden Säulen der vielfältigen dermatologischen Therapiestrategien, die ständig weiterentwickelt wurden. Diese Weiterentwicklungen betrafen sowohl die Strahlenquellen mit effektiveren Aktionsspektren (Schmalspektrum UV-B) als auch Studien zu verschiedenen Kombinationsschemata mit externen und systemischen Pharmaka.

Die Psoriasis stellt nach wie vor die Hauptindikation für eine UV-B-Therapie dar. Im Laufe der Jahre hat sich das Indikationsspektrum deutlich erweitert.

Akute Nebenwirkungen sind Sonnenbrände durch falsche Dosierungen, wichtiger sind potenzielle chronische Nebenwirkungen wie die chronische aktinische Hautschädigung, inklusive der Photokarzinogenese. Die praktische Durchführung erfordert Erfahrung, auch wenn sie in Leitlinien sehr umfassend widergegeben ist.

Capillary flows across layers and textural interfaces - Pathways and colloid transport considerations in unsaturated layered porous media

Soils and other geologic porous media often display layering and associated textural contrasts that may alter unsaturated flow and transport pathways. Such natural interfaces are usually represented empirically in continuum flow models with limited mechanistic account of the effect of adjusted pathways across layers on colloid transport and on the nature of unsaturated flow. In this study we present the soil foam drainage equation (SFDE) as alternative framework to simulate unsaturated flow in layered porous media.

HYPOTHESIS

In contrast to standard continuum flow models, the SFDE explicitly accounts for capillary flow pathways and their adjustment across textural interfaces that in turn define flow geometry for colloidal transport not predicted by continuum models.

EXPERIMENTS

Pore scale water distribution in a layered sand sample was measured using X-ray tomography to quantify capillary flow pathways. Literature values of measured saturation and capillary pressure profiles in layered porous columns were used to evaluate solutions based on the SFDE framework and to deduce velocity profiles and their effects for colloid transport.

FINDINGS

The SFDE framework provides new insights into capillary architecture in unsaturated layered media and opens a new way for using pore scale information (from imaging) to provide the necessary SFDE parameters and potentially improve on the standard continuum representation of capillary flows in layered media.

Rosacea Management: Update on general measures and topical treatment options

Although there is presently no cure for rosacea, there are several recommended treatment options available to control many of the symptoms and to prevent them from getting worse. In addition to self-help measures like avoidance of trigger factors and proper skin care, rosacea management should include topical medications as one of the first-line choices for patients with erythematous and mild to severe papulopustular rosacea. Since mixed forms of characteristic rosacea symptoms are more common, medical treatment must be symptom-tailored for each individual case and will often involve a combination therapy. Approved topical agents for the major symptoms of rosacea encompass brimonidine for erythema and ivermectin, metronidazole or azelaic acid for inflammatory lesions, all of which have shown their efficacy in numerous valid, well-controlled trials. In addition, there are several other, not approved topical treatments which are possible options that require further validation in larger well-controlled studies.

Pathogenesis and clinical presentation of rosacea as a key for a symptom-oriented therapy

Rosacea is a common chronic inflammatory skin disorder that typically occurs in adults and affects the face. Synonyms of rosacea include "acne rosacea", "couperose" and "facial erythrosis", in German also "Kupferfinne" and "Rotfinne". The disorder is characterised by a chronic and flaring course and is caused by a genetically predisposed, multifactorial process. A higher incidence is seen in people with fair skin and a positive family history. The characteristic rosacea symptoms manifest primarily, but not exclusively centrofacially, with forehead, nose, chin and cheeks significantly affected. Based on the various main symptoms a classification of the individual clinical pictures can be performed. However, a classification often does not reflect the clinical reality, since the various symptoms commonly coexist. The present review provides an introduction on pathogenesis and clinical manifestations of rosacea and prefers a symptom-oriented therapy approach.

State of the art: systemic rosacea management

Based on numerous trials, oral tetracyclines and most commonly their second-generation derivative doxycycline have become the main pillar in systemic rosacea treatment. However, the only preparation that has been approved so far in this setting is 40 mg doxycycline in an anti-inflammatory dosage and with a modified release formulation. With the introduction of this once-daily, non-antibiotic dosing of doxycycline, oral therapy is more commonly prescribed as first-line treatment in moderate to severe papulopustular rosacea. In addition, topical and oral strategies are often used in combination due to the more substantial improvements compared to monotherapy. Although several other non-approved oral agents like macrolides, isotretinoin, and carvedilol have been evaluated for systemic treatment and showed promising results, yet the experience with these drugs in rosacea is limited, and thus they should be reserved for special situations.

Pathogenese und Klinik der Rosazea als Schlüssel für eine symptomorientierte Therapie

Rosazea ist eine häufige chronisch-entzündliche Hauterkrankung, die typischerweise bei Erwachsenen vorkommt und das Gesicht betrifft. Synonyme der Rosazea sind Acne rosacea, Kupferfinne, Rotfinne, Couperose und Rosacea. Die Erkrankung ist durch einen chronischen und schubartigen Verlauf gekennzeichnet und wird durch ein genetisch prädisponiertes, multifaktorielles Geschehen bedingt. Ein vermehrtes Auftreten wird bei hellem Hauttyp und positiver Familienanamnese verzeichnet. Die charakteristischen Rosazea-Symptome manifestieren sich vorwiegend, aber nicht ausschließlich zentrofazial, wobei Stirn, Nase, Kinn und die Wangen maßgeblich betroffen sind. Dabei werden unterschiedliche Hauptsymptome voneinander unterschieden, anhand derer eine Klassifikation der verschiedenen klinischen Bilder vorgenommen werden kann. Eine Klassifizierung wird oftmals jedoch nicht der klinischen Realität gerecht, da die verschiedenen Symptome häufig gemeinsam auftreten. Diese Übersichtarbeit führt in die Pathogenese und Klinik der Rosazea ein und plädiert für einen symptomorientierten Therapieansatz.

System spectrum conversion from white light interferogram

Capability to simulate the coherence function is important when tuning an interference microscope in an effort to reduce sidelobes in interference signals. The coherence function cannot directly be derived from the light source spectrum since the microscope's effective spectrum is affected by e.g. spatial coherence effects. We show this by comparing the true system spectrum measured using a spectrometer against the effective system spectrum obtained by Fourier analysis of the interference data. The results show that a modulation function that describes the scattering-induced spatial coherence dampening in the system is needed to correct the observed difference between these two spectra. The validity of this modulation function is further verified by quantifying the arithmetic mean roughness of two specified roughness standards. By providing a spectral transfer function for scattering, our method can simulate a sample specific coherence function, and thus shows promise to increase the quality of interference microscope images.

Rosazea-Management: Update über allgemeine Maßnahmen und topische Therapieoptionen

Obwohl bislang für die Rosazea keine kurative Therapie besteht, können verschiedene Optionen zur Behandlung der Symptome und zur Vorbeugung von Exazerbationen empfohlen werden. Neben Selbsthilfemaßnahme wie der Vermeidung von Triggerfaktoren und einer geeigneten Hautpflege sollte das Rosazea-Management bei Patienten mit erythematöser und leichter bis schwerer papulopustulöser Rosazea die Anwendung topischer Präparate als First-Line-Therapie umfassen. Da Überlappungen der charakteristischen Rosazea-Symptome im klinischen Alltag die Regel sind, sollte die medikamentöse Therapie auf die individuellen Symptome zugeschnitten werden; auch eine Kombinationstherapie kann erforderlich sein. Zu den für die Behandlung der Hauptsymptome der Rosazea zugelassenen Wirkstoffen gehören Brimonidin gegen das Erythem sowie Ivermectin, Metronidazol oder Azelainsäure gegen entzündliche Läsionen. Ihre Wirksamkeit wurde in zahlreichen validen, gut kontrollierten Studien belegt. Darüber hinaus existieren verschiedene nicht zugelassene topische Behandlungsmöglichkeiten, deren Wirksamkeit und Sicherheit noch in größeren, kontrollierten Studien zu untersuchen ist.

[Lymphedema as initial manifestation of malignancy]

Lymphedema may result from various benign or malignant causes. In particular rapidly progressing central or unilateral lymphedema (even in case of only discrete clinical findings) should initiate an extensive diagnostic workup to detect underlying malignancies in order to enable early therapy.

Passive vibration compensation in scanning white-light interferometry

We present a passive vibration compensation approach in scanning white-light interferometry (SWLI). A pointwise distance measuring interferometer (DMI) obtains fast temporal distance changes during the white-light depth-scan of an aerial-measuring Michelson white-light interferometer for topography measurement. Both interferometers share a part of the optical path so that the measurement spot of the DMI is within the field of view of SWLI. With the real positions of the interferometer with respect to the measuring object during the depth scan known from DMI measurements, we can compensate for the influence of unintentional distance changes caused by environmental vibrations or scanner nonlinearities. By reordering of the captured image frames and improved correlogram interpolation, we are able to reconstruct correct signals from completely distorted (and unusable) SWLI signals. Although the basic idea of the system already has been published, we improved the signal reconstruction technique so that the specimen's topography measurement can be obtained with the same accuracy as without any vibrations or scan distortions influence. In addition, we demonstrate the feasibility of the approach by different practical measurements with and without vibrations.

PCR analysis is superior to histology for diagnosis of Whipple's disease mimicking seronegative rheumatic diseases

OBJECTIVES

The diagnosis of Whipple's disease (WD) is commonly confirmed by histology demonstrating Periodic Acid Schiff (PAS)-positive macrophages in the duodenal mucosa. Analysis of intestinal tissue or other specimens using polymerase chain reaction (PCR) is a more sensitive method. However, the relevance of positive PCR findings is still controversial. Therefore, we evaluated the relevance of histology and PCR findings to establishing the diagnosis of WD in a series of WD patients initially presenting with suspected rheumatic diseases.

METHOD

Between 2006 and 2014, 20 patients with seronegative rheumatic diseases tested positive for Tropheryma whipplei (Tw) by PCR and/or histology and were enrolled in a retrospective analysis of the diagnostic value of both procedures.

RESULTS

Seven of the 20 cases (35%) were diagnosed with 'classic' WD as indicated by PAS-positive macrophages. In the remaining 13 patients, the presence of Tw was detected by intestinal (n = 10) or synovial PCR analysis (n = 3). Two of the 20 patients (10%) with evidence of Tw did not respond to antibiotic therapy. They were not considered to suffer from WD. Therefore, relying only on histological findings of intestinal biopsies would have missed 11 (61%) of the 18 patients with WD in our cohort. In comparison, PCR of intestinal biopsies detected Tw-DNA in 14 (93%) of the 15 WD patients evaluated. Patients with a positive histology did not differ from PCR-positive patients with regard to sex, age, or duration of disease, but more often presented with gastrointestinal symptoms.

CONCLUSIONS

A substantial number of WD patients present without typical intestinal histology findings. Additional PCR analysis of intestinal tissue or synovial fluid increased the sensitivity of the diagnostic evaluation and should be considered particularly in patients presenting with atypical seronegative rheumatic diseases and a high-risk profile for WD.

Signal modeling in low coherence interference microscopy on example of rectangular grating

Besides the illumination wavelength also the numerical aperture (NA) of a microscope objective affects the fringe spacing in interference microscopy. Therefore, at high NA values an effective wavelength should be obtained by calibration. At step height structures both, the effective wavelength and the batwing effect strongly depend on the height-to-wavelength-ratio (HWR). Therefore, changes of the effective wavelength considering temporal and spatial coherence enable us to estimate the batwing effect in measurement results. For high NA systems and broadband illumination two different theoretical approaches for signal modeling are introduced to study the influence of the center wavelength, the temporal, and the spatial coherence of the illuminating light on measurement results of a rectangular grating. In both models diffraction is considered. While the first simulation model (Kirchhoff) is mostly analytical the second one (Richards-Wolf) is primarily numerical. Simulation results of both models show a good agreement with experimental measurement results.

Domestic Violence Perpetrator Programs: A Proposal for Evidence-Based Standards in the United States

In the United States, the judicial system response to violence between intimate partners, or intimate partner violence (IPV), typically mandates that adjudicated perpetrators complete a batterer intervention program (BIP). The social science data has found that these programs, on the whole, are only minimally effective in reducing rates of IPV. The authors examined the social science literature on the characteristics and efficacy of BIPs. More than 400 studies were considered, including a sweeping, recently conducted survey of BIP directors across the United States and Canada. Results of this review indicate that the limitations of BIPs are due, in large part, to the limitations of current state standards regulating these programs and, furthermore, that these standards are not grounded in the body of empirical research evidence or best practices. The authors, all of whom have considerable expertise in the area of domestic violence perpetrator treatment, conducted an exhaustive investigation of the following key intervention areas: overall effectiveness of BIPs; length of treatment/length of group sessions; number of group participants and number of facilitators; group format and curriculum; assessment protocol and instruments; victim contact; modality of treatment; differential treatment; working with female perpetrators; working with perpetrators in racial and ethnic minority groups; working with lesbian, gay, bisexual, and transgender (LGBT) perpetrators; perpetrator treatment and practitioner–client relationships; and required practitioner education and training. Recommendations for evidence-based national BIP standards were made based on findings from this review.

Brimonidine gel 0.33% rapidly improves patient-reported outcomes by controlling facial erythema of rosacea: a randomized, double-blind, vehicle-controlled study

Background

Facial redness contributes to impaired psychosocial functioning in rosacea patients and the only approved treatment for erythema is topical brimonidine gel 0.33%.

Objectives

To evaluate patient‐reported outcomes, as well as efficacy and safety, in subjects with self‐perceived severe erythema treated with brimonidine gel 0.33% compared to vehicle.

Methods

An 8‐day multicenter, randomized study comparing once‐daily brimonidine gel 0.33% with vehicle gel using a facial redness questionnaire, subject satisfaction questionnaire and a patient diary of facial redness control to assess patient‐reported outcomes.

Results

Of the 92 included subjects with self‐perceived severe erythema, very few were satisfied with their appearance at baseline (4.2% brimonidine group, 0 vehicle group). On Day 8, significantly more brimonidine group subjects were satisfied with their facial appearance compared to vehicle group (36.9% vs. 21.5%; P < 0.05), with the overall treatment effect (69.6% vs. 40.4%; P < 0.01), and with the improvement in their facial redness (67.4% vs. 33.3%; P < 0.001). More brimonidine group subjects were able to control their facial redness daily (e.g. 83.0% vs. 38.9% on Day 1). On Day 8, significantly more brimonidine group subjects than vehicle group had at least a one‐grade improvement from baseline in the Clinician Erythema Assessment score (71.7% vs. 35.7%; P = 0.0011) and Patient Self‐Assessment score (76.1% vs. 47.6%; P = 0.004). More subjects in the brimonidine group (29.2%) reported treatment‐related adverse events than in the vehicle group (15.9%) but most were mild and transient.

Conclusions

Once‐daily brimonidine gel 0.33% allowed patients to rapidly control their facial redness and significantly improved patient‐reported outcomes in the treatment of persistent facial erythema of rosacea.

Effects of stomata clustering on leaf gas exchange

A general theoretical framework for quantifying the stomatal clustering effects on leaf gaseous diffusive conductance was developed and tested. The theory accounts for stomatal spacing and interactions among 'gaseous concentration shells'. The theory was tested using the unique measurements of Dow et al. (2014) that have shown lower leaf diffusive conductance for a genotype of Arabidopsis thaliana with clustered stomata relative to uniformly distributed stomata of similar size and density. The model accounts for gaseous diffusion: through stomatal pores; via concentration shells forming at pore apertures that vary with stomata spacing and are thus altered by clustering; and across the adjacent air boundary layer. Analytical approximations were derived and validated using a numerical model for 3D diffusion equation. Stomata clustering increases the interactions among concentration shells resulting in larger diffusive resistance that may reduce fluxes by 5-15%. A similar reduction in conductance was found for clusters formed by networks of veins. The study resolves ambiguities found in the literature concerning stomata end-corrections and stomatal shape, and provides a new stomata density threshold for diffusive interactions of overlapping vapor shells. The predicted reduction in gaseous exchange due to clustering, suggests that guard cell function is impaired, limiting stomatal aperture opening.